3-28 Physical Fitness Facility Medical Emergency Preparedness

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1 Approved 09/14/ Physical Fitness Facility Medical Emergency Preparedness I. Medical Emergency Plan Required For each physical fitness facility owned or operated by the School District, the Administration shall adopt and implement a written plan for responding to medical emergencies that occur at the facility during the time the facility is open for use by the School District or by the public. Each plan shall comply with the Physical Fitness Medical Emergency Preparedness Act ( Act ) and the rules adopted by the Illinois Department of Public Health ( Department ) to implement the Act. The Administration shall file a copy of each plan with the Department upon the plan s initial adoption and whenever the plan is updated due to a change in the structure occupied by the facility or in the services provided or offered that would materially affect the facility s ability to respond to a medical emergency. II. Physical Fitness Facility Defined A. The term, physical fitness facility ( facility ) is defined as follows: (1) indoor facilities that are owned or operated by the District and supervised by one or more persons, other than maintenance or security personnel, employed by the District for the purpose of directly supervising the physical fitness activities taking place at any of these indoor facilities: a swimming pool; stadium; athletic field; track and field facility; tennis court; basketball court; or volleyball court; or such facilities located adjacent thereto, and (2) except as provided in paragraph II.B below, the term physical fitness facility is also defined as any other indoor establishment where the District provides services or facilities focusing primarily on cardiovascular exertion. B. The term physical fitness facility does not include a facility serving less than 100 individuals. In addition, the term does not include any outdoor facility. The term does not include any facility that does not employ any persons to provide instruction, training, or assistance for persons using the facility. also III. IV. Automated External Defibrillator Required Consistent with the compliance schedule set forth in the Act, July 1, 2006, the Administration shall provide and make available an automated external defibrillator ( AED ) and a trained AED user on staff on the premises of each of its physical fitness facilities. Further, by the same compliance date, the District shall ensure that every AED on the facility s premises is properly tested and maintained. Training Required The Administration shall ensure that staff is trained and present in each facility in a manner consistent with the Act and rules adopted by the document. V. Rules and Regulations The Superintendent is authorized to establish rules and regulations designed to implement this Policy and consistent with the regulations published by the Department. Legal Reference: Physical Fitness Facility Medical Emergency Preparedness Act, 210 ILCS 74 Automated External Defibrillator Act, 410 ILCS 4/1 et seq 77 Ill. Adm. Code 527

2 NORTHERN SUBURBAN SPECIAL EDUCATION DISTRICT 760 Red Oak Lane Highland Park, IL (847) FAX (847) Facility AED Preparedness Response PURPOSE: To provide guidance in management or administration of facility based AED Program. To provide treatment of victims over 1 year of age. To assist in the development and revision as needed of the PAD Program policies and procedures. AED unit (s) will be registered with Saint Francis Emergency Medical Services System Public Access Defibrillation program-saint Francis Hospital, Evanston, Illinois. Northern Suburban Special Education District will forward a copy of the Facility AED Preparedness Response will be forwarded to Illinois Department of Public Health-Division of EMS & Highway Safety West Jefferson Street-Springfield, IL Preparedness Response will be updated as needed. PROGRAM OVERVIEW: An estimated 250,000 Americans die each year of sudden cardiac arrest before they reach a hospital. Sudden cardiac arrest is usually caused by a heart rhythm called ventricular fibrillation. Each minute is critical in helping the person restore a normal heart rhythm. The key to survival is the speed of response. In addition to cardiopulmonary resuscitation (CPR), most cardiac arrest victims need immediate electrical shock to restore the heart s normal rhythm. It is estimated that for each minute that passes without defibrillation occurring, the person s chance of survival drops by 10 percent (American Heart Association). Automatic External Defibrillators (AED) Locations: ECCIL (Early Childhood Center for Innovative Learning) North Shore Academy North Shore Academy Elementary AED s will be installed in strategically selected locations within the buildings. AED locations will be clearly marked.

3 Location needs to be reached in 90 seconds from any location within the building. Each facility must ensure that every AED on the facility s premises is properly tested and maintained in accordance with rules adopted by Illinois Department of Public Health. Each AED location will have available: CPR Ready Reference information Automated External Defibrillator Battery Electrodes (Adult and Pediatric) One spare set of Adult and Pediatric electrodes Pouch with towel, scissors, razor, facemask barrier device, and gloves First responder list Public Access Defibrillation Utilization Forms for Saint Francis EMS System Training: Early CPR and early defibrillation is an integral part of providing lifesaving aid to people suffering sudden cardiac arrest. The ventilation and compression skills learned in a CPR class are needed to help circulate oxygen rich blood to the brain, until defibrillation is possible. CPR Training will be provided using American Heart Association-Heart Saver AED Certification. Training will include adult/child and infant CPR and foreign body airway obstruction, as well as AED usage. Training will be provided at no cost for NSSED employees who may be required to provide assistance. Other district (s) personnel may request the training at district expense. Requests for training should be directed to the Health Coordinator (Juanita Weckerlin CSN) CPR Training Coordinator will keep list of current certified staff, and make list available as needed. American Heart Association CPR/AED training certification is valid for two years. First Responder List: A list of trained responders for each building will be updated annually to include persons on staff who are trained in CPR/AED usage.

4 TERMINOLOGY: AED Automated External Defibrillator- a medical device heart monitor and defibrillator that: is capable of recognizing the presence or absence of ventricular fibrillation and rapid ventricular tachycardia, and is capable of determining, without intervention of the operator, whether defibrillation should be performed. Upon determining that defibrillation should be performed, either automatically charges and delivers an electrical impulse to an individual, or charges and delivers an electrical impulse at the command of the operator; and in the case of a defibrillator that may be operated in either an automatic or manual mode, is set to operate in the automatic mode (Section 10 of Act). An AED is only applied to victims who are unconscious, without a pulse, signs of circulation and normal breathing. Ages per American Heart Association = Adult (over 8 years old) Child (1-8 years old) Infant (under 1 year old) CPR- maneuvers to attempt to restore spontaneous circulation using techniques of chest wall compression and pulmonary ventilation to provide an adequate supply of oxygen to the brain until medical help arrives. Defibrillation-administering an electrical impulse to an individual in order to stop ventricular fibrillation or rapid ventricular tachycardia. EMS-Emergency Medical Services System- an organization of hospitals, vehicle service providers and personnel approved by the Department in a specific geographic area, which coordinates and provides pre-hospital and inter-hospital emergency care and non-emergency medical transports. PAD-Public Access to Defibrillation Sudden Cardiac Arrest (SCA) - is a condition that occurs when the electrical impulses of the human heart malfunction causing a disturbance in the heart s electrical rhythm called ventricular fibrillation (VF).

5 This erratic and ineffective electrical heart rhythm causes complete cessation of the heart s normal function of pumping blood resulting in sudden death. The most effective treatment of this condition is the administration of an electrical current to the heart by a defibrillator, delivered within a short time of the onset of VF. First Responder Procedures: Chain of Survival per American Heart Association: 1. Early access. Call 911 ; Cell phone call * Early CPR 3. Early Defibrillation 4. Early Advanced Care (Paramedics, hospital care) EARLY DEFIBRILLATION RESPONSE: DURING AND AFTER SCHOOL HOURS 1. Assess scene for safety; use universal precautions. Substances: blood or other body fluids, noxious fumes, toxic chemicals, etc. Situational dangers: armed perpetrator, weapons, animals, etc. Environmental dangers: unstable structure, fire, electrical hazards, etc. 2. Assess victim for response: Gently shake the victim and shout Are you OK? 3. Phone 911: If there is no response, phone 911(or other emergency response number) and get the AED. If anyone is near, direct them to phone 911 and get the AED. Tell dispatcher where the victim is located (specific location-building, room, if any extenuating circumstances exist) If possible someone should meet the rescuers, and direct them to the scene. Phoning 911 will activate the EMS system and makes sure that professional help is on they way. 4. Check ABC s of CPR (Airway; Breathing; Circulation) Assess Airway and Breathing. Open airway- Perform head tilt-chin lift or jaw thrust. Look, listen and feel for breathing. If breathing is absent, use facemask barrier device to deliver two rescue breaths. (If adult victim is not breathing normally (gasping), but has signs of circulation= give one breath every 5 seconds. If child or infant is not breathing normally, but has signs of circulation=give one breath every 3 seconds.

6 5. Assess Circulation. Check for pulse or other signs of circulation (coughing, breathing or movement for a maximum of 10 seconds. If no signs of circulation are present, open clothes, begin compressions. Adult Child Infant (over 8 years old) (1-8 years old) (under 1 year old) Locate compression between nipples between nipples, lower one finger width below landmark: ½ of sternum nipple line Compressions are 2 hands stacked, heel heel of one hand on 2 fingers-1 finger width performed with: of hands between nipples lower ½ of sternum below nipple line Rate of compressions: per minute: Compression depth: 1 ½ - 2 inches 1-1 ½ inches ½-1 inch Ratio compression to Breaths (1 or 2 rescuers): 15:2 5:1 5:1 Check for signs of circulation (pulse, breathing, coughing or movement) after one minute of care and every few minutes after that. Continue CPR until defibrillator arrives. 6. Begin defibrillation treatment. As soon as defibrillator arrives, turn power on, and follow voice prompts. Remove clothing from victim s chest Place AED near head of victim, and on same side as rescuer. Open AED electrode pad package, and attach according to pictures (if victim is less than 8 years old = use pediatric defibrillator pads). Wipe Chest if wet with towel from AED kit Shave chest with disposable razor if needed (pads must make good contact with chest) Do not place pads over the nipple, medication patches or visible implanted devices Clear the victim and allow the AED to check the heart rhythm The AED will advise if a shock is needed. If shock is advised = Clear the victim, and press the shock button as advised. The victim s muscles

7 will jerk. Administer additional shocks as prompted by the defibrillator, until it advised no shock or has delivered a series of three consecutive shocks and prompts the responder to check the patient. When advised by the defibrillator, check the victim s airway, breathing and signs of circulation, and initiate CPR if no signs of circulation are present. Continue to perform CPR until otherwise prompted by the defibrillator or EMS personnel arrive. If breathing and other signs of circulation are present, leave the defibrillator attached and place the victim in recovery position. Continue to monitor the victim s airway, breathing and circulation and provide any of the above steps as needed. 7. When EMS arrives Responders working on a victim will need to document and communicate information to EMS providers, such as: Victim s name Known medical problems, allergies or medical history Time the victim was found Initial and current condition of victim Any information stored on the AED (data card from AED may be removed for evaluation of information. Notify family member of incident necessitating emergency care and provide information regarding where victim has been taken. If student - principal or designate will contact family member. POST -USE PROCEDURE: Nurse Coordinator will notify Saint Francis EMS System, by telephone within 24 hours of any event, incident or situation that results in the use or possible use of the AED. Within 72 hours Public Access Defibrillation Utilization form will be will be submitted to EMS Office at Saint Francis Hospital. (copy of Public Access Defibrillation Utilization Form attached) The Saint Francis EMS System will forward copies of the documentation to Illinois Department of Public Health. Defibrillator will be checked by Nurse Coordinator and any supplies will be replaced as needed, so defibrillator may be returned to service. Any after use maintenance will be requested to be performed.

8 EQUIPMENT MAINTENANCE: All equipment and accessories necessary for support of medical emergency response shall be maintained in a state of readiness. Maintain on file specifications/technical information for each approved AED model. Facility of AED shall be informed of changes in availability of emergency medical response equipment, and will be informed when equipment is returned to service Regular equipment maintenance will be performed as needed. All maintenance tasks shall be performed according to equipment maintenance procedures as outlined in the operating instructions. Following use of emergency response equipment, all equipment shall be cleaned and/or decontaminated as required. If contamination includes body fluids, the equipment shall be disinfected according to manufacturer s guidelines. ROUTINE MAINTENANCE: The AED will perform a self-diagnostic test every 24 hours that includes a check of battery strength and an evaluation of the internal components. Daily AED checks will be performed following the procedure checklist, per manufacturer s information. The procedure checklist will be signed at the completion of the daily check. The procedure checklist will be posted with the AED. District Building Maintenance personnel will conduct daily AED check on days when district offices are open. If the battery icon indicates any discrepancy, the battery will be replaced as needed. If the AED icons indicate service needed-maintenance service will be requested. Loaner AED will be requested if possible. Expiration date of electrodes will be posted on AED cabinet, so expiration date can be viewed easily. If expiration date on the electrodes is near, Program Coordinator will order new ones. Battery life is approximately 2 years. Approximate battery expiration date will be posted on AED cabinet, so as expiration date can be viewed easily. New batteries can be requested prior to expiration date, and be replaced as needed.

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